M-Spike, High Kappa and Kappa/Lambda Ratio

Posted by Kappa King @kappaking, Mar 8 10:34pm

After experiencing chronic diarrhea for > four weeks, I decided to contact my gastro doctor. He ordered blood work and performed a colonoscopy and upper endoscopy with various biopsies. The colonoscopy, upper endoscopy and biopsies showed no sign of cancer or microscopic colitis, however the blood work showed a quite elevated IgA level. He referred me to a hematologist/oncologist who did further blood work, the results of which showed:

• Borderline low white blood count
• Borderline high red cell distribution width
• Low lymphocytes
• Low monocytes

And the most troublesome results:

• Kappa Free Light Chain Level: 290.7 mg/L, well outside of the 3.3-19.4 mg/L acceptable range
• Kappa/Lambda Ratio: 45, well outside of the .26-1.65 acceptable range
• IgA Level: 2111 mg/dL, well outside of the 70-400 mg/dL acceptable range
• IgG level of 698 mg/dL, barely outside of the 700-1660 mg/dL
• M-Spike: 1.29

There are other data points outside the reference ranges, but these are the ones that concern me most. I had been overseas when I received the results and asked my hematologist if I should cut my vacation short to come home for further evaluation/tests. He urged me not to do so and told me it can wait. I managed to enjoy my vacation but now that I returned I can't stop worrying. I'm following up with my hematologist to see what the next step is. I'm scared.

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junipergin | @juniperjgin | May 4 11:56pm

In reply to @aczatx47131 "On SmartPatients.com. I am ClaireATX. You can read my health profile and posts there." + (show)

Smart Patients is a helpful and generally encouraging platform.
So many people with great knowledge gained through experience and serious research are very willing to help when you reach out!
People like:
ClaireATX

aczatx47131 | @aczatx47131 | May 5 6:43am

In reply to @juniperjgin "Smart Patients is a helpful and generally encouraging platform. So many people with great knowledge gained..." + (show)

Thank you, junipergin!

I agree with you about SmartPatients.com

sandy4053 | @sandy4053 | May 6 12:40pm

In reply to @pmm "@sandy4053 Fingers crossed that you have a productive visit And are reassured after talking to your..." + (show)

I had my appointment with the hematologist/oncologist this morning. His first words, after looking at my results, was "You don't have cancer. You have something called MGUS." Of course, after having found this page, I was SO relieved. Not that it can't advance to MM, but he said at my age (nearing 80) it's more unlikely that it will be an issue for me. He is scheduling another bone marrow test (had one in May 2022) for comparison. He said that the count was 0.3 and they didn't consider it MM until it reached at least 2-3 (can't remember what the particular test was now. I was very relieved after meeting with him. I'm so appreciative of this page. I felt much better about reading everyone's post and how they dealt with it. My hematologist/oncologist will be checking me every 6 months, at the most. He told me that Mayo Clinic had done the initial studies on MGUS and that finding this page was a good thing for me. Thank you for responding to my post. It helps when someone else can share their experience...makes it a little less scary. I'm praying that it stays under control and know that life will just continue. I just need to be sure that I keep working with him. My PCP just didn't seem too interested in finding out what was going on with me. I think they just have too many patients these days. Thank you again for your encouragement, not only to me, but everyone here.

Patty, Volunteer Mentor | @pmm | May 6 1:11pm

In reply to @sandy4053 "I had my appointment with the hematologist/oncologist this morning. His first words, after looking at my..." + (show)

@sandy4053
Well, that is good news. It’s not that MGUS is insignificant, but there are many people on this forum who have lived with it for many, many years.
It sounds as though your physician is going to be diligent with your care. I think it’s safe to say that you can expect some dips and peaks of your various lab results, but your diligent physician will keep track of all that with you and if necessary, will go over treatment options if it ever comes to that.
I am so encouraged that there have been such gains in the treatment of full blown multiple myeloma. The prognosis is much better than even 10 years ago.
But I vote that we don’t do that!
I hope that this news will help you relax and feel some calm and peace.
Hugs!

2121 | @leslie2121 | May 6 1:26pm

In reply to @sandy4053 "I had my appointment with the hematologist/oncologist this morning. His first words, after looking at my..." + (show)

That’s reassuring! I’m kind of surprised he wants to do another bone marrow biopsy, especially with your low number.

Patty, Volunteer Mentor | @pmm | May 7 9:12am

In reply to @leslie2121 "That’s reassuring! I’m kind of surprised he wants to do another bone marrow biopsy, especially with..." + (show)

@leslie2121
That’s a very valid point.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757684/#:~:text=When%20do%20we%20perform%20skeletal,these%20tests%20(Figure%201).
@sandy4053 you might inquire about the necessity. For what reason is your doc ordering another BM done?

sandy4053 | @sandy4053 | May 7 11:09am

In reply to @leslie2121 "That’s reassuring! I’m kind of surprised he wants to do another bone marrow biopsy, especially with..." + (show)

Because I'm dealing with anemia that has been ongoing for many years, he just wants to see if there's been any change in counts since 2 years ago. He said the comparison will help him determine the next steps for the anemia issue.

sandy4053 | @sandy4053 | May 7 11:11am

In reply to @pmm "@leslie2121 That’s a very valid point. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5757684/#:~:text=When%20do%20we%20perform%20skeletal,these%20tests%20(Figure%201). @sandy4053 you might inquire about the necessity. For what..." + (show)

My last bone marrow biopsy was normal and he wants to have a comparison since the other numbers have changed. After discussing the reasons with him, I decided that it was good information for him to have to determine where to go next.

Patty, Volunteer Mentor | @pmm | May 7 11:35am

@sandy4053
Well that makes sense.